冠状动脉支架治疗心肌梗死的发展趋势

Coronary stenting for myocardial infarction: its developmental trends

背景:冠状动脉支架可以有效防止动脉血管因脂肪堆积而出现阻塞或狭窄,改善心肌梗死患者的心脏功能,防范应用于临床。目的:分析2004至2015年Medline、中国知网、万方数据库收录的不同类型冠状动脉支架治疗心肌梗死的临床研究及北美临床试验注册中心和中国临床试验注册中心注册的不同类型冠状动脉支架治疗心肌梗死的临床项目的发展趋势。方法:1被收录的文章及以关键词"stent"(支架),"myocardial infarction"(心肌梗死)进行检索。2检索文献时间范围12年(2004至2015年),分为3个统计时间段:2004至2007年、2008至2011年、2012至2015年。3检索信息源:Medline、中国知网、万方数据库及北美临床试验注册中心和中国临床试验注册中心的临床试验项目。4对金属裸支架、药物覆膜支架和生物可降解支架分别进行统计。结果与结论:1在Medline数据库,2004至2015年关于冠状动脉支架治疗心肌梗死临床研究的文献共720篇,其中药物覆膜支架在2004至2007年、2008至2011年、2012至2015年时间段中文献数量持续上升,而金属裸支架在2008至2011年达到峰值后下降,可降解支架在2008年后才逐渐出现,数量持续增加。中国知网和万方数据库收录的不同时间段不同类型的冠状动脉支架治疗心肌梗死临床研究的文献中,金属裸支架治疗心肌梗死的文章数量处以较低水平,而药物覆膜支架在2008至2011年是数量最多,国内可降解支架较为少见。2在北美临床试验注册中心注册的心血管支架材料生物相容性相关临床试验注册项目中,金属裸支架研究项目数量相对较少,药物覆膜支架在2012至2015年时明显减少,而可降解支架治疗心肌梗死的研究项目数量呈增长的趋势。

BACKGROUND： Coronary stenting can effectively prevent the artery blood vessels against obstruction or stenosis due to fat accumulation and improve cardiac function in patients with myocardial infarction. OBJECTIVE： To analyze the clinical trends of different types of coronary stents for myocardial infarction reported from 2004 to 2015 in Medline, CNKI, Wanfang, Clinical Trials.gov and Chinese Clinical Trial Register. METHODS： The relevant articles addressing metal bare stents, drug-eluting stents, and biodegradable stents were retrieved using the keywords of ＂stent＂ and ＂myocardial infarction＂ in Chinese and English in Medline, CNKI,Wanfang, Clinical Trials.gov and Chinese Clinical Trial Register followed by statistical analysis. The retrieval time was from 2004 to 2015, including 2004-2007, 2008-2011 and 2012-2015. RESULTS AND CONCLUSION：（1） In Medline database, there were 720 clinical studies about coronary stenting for myocardial infarction published from 2004 to 2015. The number of articles addressing drug-eluting stents continued to increase from 2004 to 2007, 2008 to 2011 and 2012 to 2015. The number of articles addressing metal bare stents reached the peak from 2008 to 2011, and then decreased. Biodegradable stents appeared after 2008, and the number of relevant articles was increased gradually. In CNKI and Wanfang databases, the number of metal bare stents for myocardial infarction was at a lower level, while the number of drug-eluting stents was peaked from 2008 to 2011, and at that time, biodegradable stents were rarely reported in China.（2） In Clinical Trials.gov, the number of clinical trials about metal bare stents for myocardial infarction was relatively low, the number of clinical trials about drug-eluting stents was reduced dramatically from 2012 to 2015, but the number of clinical trials about biodegradable stents for myocardial infarction had a rising trend.